We’ve been asked to talk about harm reduction programs. You may have seen the Rev. Zac Morton’s letter to the editor last Sunday or the WVU Today piece, “Connected epidemics: HIV and opioids” published Monday, both of which reference harm reduction programs.
Let’s start simple: What is a harm reduction program? According to Harm Reduction International: “Harm reduction refers to policies, programs and practices that aim to minimize negative health, social and legal impacts associated with drug use, drug policies and drug laws. Harm reduction … focuses on positive change and on working with people without judgment, coercion, discrimination or requiring that they stop using drugs as a precondition of support.”
In short, harm reduction programs are a compassionate approach to addiction. Such programs can offer a variety of services, from needle exchanges to substance abuse recovery services to naloxone distribution to STD testing and treatment. If we had to sum it up, we’d say harm reduction programs operate on the principle that a person needs to want help to be helped, but he/she has to stay alive long enough to get help.
In our area, Milan Puskar Health Right provides these services. According to its website, the organization offers: Syringe access kits, safe syringe disposal, naloxone prescriptions, HIV and Hepatitis C testing, wound care, addiction treatment referrals, opportunities for primary care, family planning materials, mental health counseling, peer support, social service referrals and a safe place to discuss drug use and convey needs.
Needle exchanges or syringe service programs are perhaps one of the most visible — and controversial — elements of harm reduction. Some argue clean needle initiatives only encourage further intravenous drug use; others point out that the circulation of dirty needles can and does lead to bloodborne pathogen outbreaks, such as HIV and hepatitis, as infected blood from one syringe user gets passed onto the next user.
Part of the reason harm reduction programs offer STD screening and treatment is because many of the same diseases we think of as being sexually transmitted can be — and often are — spread through the use of dirty needles. To give a recent example, West Virginia Public Broadcasting’s “West Virginia Morning” reported Kanawha County saw a dramatic increase in diseases linked to dirty needles after the county closed its harm reduction program in 2018. The WVU Today article cited an outbreak in Kanawha County, which saw 37 new cases of HIV in 2020; New York City had 36 cases in 2019.
HIV in particular is stigmatized as a “gay” disease — sexually transmitted between same-sex couples — but of the 37 cases in Kanawha County, 35 were the result of intravenous drug use. The infectious disease outbreak had nothing to do with sexuality and everything to do with the opioid epidemic that has crippled our state.
Addiction will continue to plague West Virginia for years, because there is no simple, singular solution. There are many roads that lead to substance use disorder, and just as many that lead to recovery. Harm reduction programs can give people the tools and support they need to find their way back to sobriety.
